Narcissistic personality disorder and related concepts have a complex history and have been subject to extensive theoretical discourse but relatively little empirical research. An initial proposal for the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) that suggested eliminating this disorder as a discrete personality disorder type met with considerable controversy that ultimately led to its reinstatement in subsequent proposals. Nonetheless, the DSM-5 proposal for personality disorders as a whole would involve a significantly different formulation of narcissistic personality from that described in DSM-IV-one that places a greater emphasis on shared deficits among all personality disorders that tap elements thought to fall on the narcissistic spectrum, such as deficits in empathic capacity. This article describes this revised formulation, and presents a case study that illustrates the similarities and differences in the DSM-IV and proposed DSM-5 portrayal of narcissistic issues and related clinical problems over the course of a particular treatment.

A single-subject design was used to investigate the impact of a dietary change on the emotional state of four individuals selected by means of the Behavioral Index of Metabolic Imbalance and a subsequent interview. The dietary change for three subjects consisted of a high protein-low carbohydrate diet void of sucrose and caffeine, whereas only caffeine and sucrose were eliminated for the fourth subject. The dependent variable used with the first subject was a self-report of symptoms experienced, whereas the Minnesota Multiphasic Personality Inventory (MMPI) and the Profile of Mood State (POMS) were used with the other subjects. Results revealed that subjects reported many symptoms and/or presented a distressed profile during baseline assessment. However, following a 2-week dietary change symptoms declined, and the MMPI or POMS profiles reflected a more stable and less distressed individual. Overall, the results suggest that a dietary change can remediate the emotional distress exhibited by some individuals.

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Individuals tend to adopt either analytic or holistic modes of categorizing objects. In two studies, we examined the relation between these categorization tendencies and cognitive abilities as measured by standard psychometric instruments. The participants in both studies were pretested with a restricted classification task in which it was possible for them to classify simple stimuli by dimensional identity or overall similarity. Those making a large number of either type of categorization were then tested with subtests of the WAIS-R and with the Raven's progressive matrices. Across both studies, the analytic individuals (many dimensional identity classifications) scored higher than the holistic individuals (many overall similarity classifications) on some but not all of the subtests. The results are consistent with the idea that holistic modes of categorization may be more "primitive" than analytic modes. The findings are discussed in terms of the association between categorization mode and either general or specific cognitive abilities.